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General NPI Number Information
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NPI Number | 1194840363
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Entity Type | Organization
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Legal Business Name | MAXUS INC.
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 07/30/2013
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Provider Practice Location Address
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Address Line | 4001 COMMERCIAL CENTER DRIVE SUITE 2
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City | MARION
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State | AR
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Zip | 72364-2361
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Country | US
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Telephone | 870-735-4441
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Fax | 870-735-5441
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Provider Business Mailing Address
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Address Line | 1033 OLD BURR RD
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City | WARM SPRINGS
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State | AR
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Zip | 72478-9077
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Country | US
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Telephone | 870-647-1400
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Fax | 870-647-2337
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Authorized Official
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Title or Position | CEO
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Name | MR. TED SUHL
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Credential |
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Telephone | 870-647-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | AR
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